Help patients navigate
financial assistance
Guidance for eligibility, documentation, and next steps.
Triple Aim Health Foundation provides financial assistance to eligible patients facing qualifying out-of-pocket costs for prescribed treatment. Healthcare providers and care teams may help patients understand the requirements, prepare documentation, and provide relevant treatment information.
Questions about a patient? Contact Triple Aim
Applications Are Closed
The program is not currently accepting new applications. Enter your email to be notified when availability changes.
Could your patient qualify?
A patient generally must meet all of the following requirements:
Qualifying insurance
The patient must be enrolled in Medicare Part D and meet the insurance requirements of the program.
Eligible diagnosis and prescribed treatment
The patient must have a qualifying diagnosis and a valid prescription for an eligible specialty treatment.
Household income within program guidelines
Household income must generally be at or below 300% of the Federal Poverty Level.
View Current Federal Poverty GuidelinesU.S. residence and treatment
The patient must reside and receive treatment in the United States or a U.S. territory. U.S. citizenship is not required.
Qualifying out-of-pocket costs
The patient must be responsible for qualifying out-of-pocket costs associated with prescribed treatment.
Meeting the eligibility requirements does not guarantee approval. Final eligibility is determined after review of a complete application and required supporting documentation. Assistance is subject to available funding.
How providers and care teams can help
Review requirements
Help patients understand current eligibility requirements and the information needed to apply.
Prepare documentation
Help patients gather required insurance, financial, diagnosis, prescription, and treatment information.
Provide relevant clinical information
Respond to requests for diagnosis, prescription, treatment, or provider information needed for eligibility review.
Triple Aim makes all final eligibility determinations under established program requirements.
Specialty treatments previously supported
Treatments previously supported by Triple Aim have been used across several areas of care, including:
- Rheumatologic and autoimmune conditions
- Inflammatory bowel diseases
- Immunologic conditions
- Allergic and inflammatory conditions
- Osteoporosis and certain bone-health conditions
This list is illustrative, not exhaustive, and does not establish patient eligibility.
Is your patient’s prescribed treatment potentially eligible?
Search by generic or brand name to see whether a prescribed treatment has previously been supported. A treatment’s appearance in the results does not establish patient eligibility.
Try a generic name, such as infliximab, or a brand name, such as Remicade.
Help your patient prepare
When applications are open, patients should be prepared to provide the information and documentation needed for eligibility review.
Patient information
- Name and contact information
- Residence information
Insurance information
- Medicare Part D information
- Relevant insurance details
Financial information
- Household income information
- Required supporting documentation
Clinical information
- Qualifying diagnosis
- Prescribed treatment
- Prescribing provider name and contact information
Care teams may be asked to provide or confirm relevant diagnosis, prescription, or treatment information as part of the eligibility review.
How the application process works
Review eligibility
Confirm that the patient appears to meet current requirements and that applications are open.
Prepare the application
Help gather required patient, insurance, financial, diagnosis, prescription, and treatment information.
Submit the application
When applications are open, the patient or an authorized person submits the required information and supporting documentation.
Triple Aim reviews eligibility
Triple Aim reviews the completed application and communicates the eligibility determination.
Clinical decisions stay with providers
Triple Aim Health Foundation does not prescribe treatment or make medical decisions. Clinical decisions remain between patients and their healthcare providers. Triple Aim independently determines eligibility and assistance awards under established program requirements and available funding. Donors do not select individual patients or determine eligibility or award amounts.
Frequently asked questions
The current assistance program is intended for eligible patients enrolled in Medicare Part D.
Patients must also meet all other applicable program requirements.
Household income must generally be at or below 300% of the Federal Poverty Level.
Meeting the income requirement alone does not guarantee eligibility.
View Current Federal Poverty GuidelinesNo.
A prescribed treatment being listed is only one part of eligibility. The patient must also meet applicable diagnosis, insurance, financial, residence, and other program requirements. Assistance is subject to available funding.
Healthcare providers and care teams may assist patients with the application process and provide information needed for eligibility review.
When applications are open, application instructions will explain how information may be submitted or completed on a patient’s behalf.
Triple Aim may ask your office to provide or confirm information related to the patient’s diagnosis, prescribed treatment, prescriber, or other information necessary for eligibility review.
Specific requirements will be identified during the application process.
Patient eligibility is not based on referral from or treatment at a particular medical practice.
If administrative information is required from a dispensing provider or pharmacy for payment processing, separate instructions will be provided.
Treatment decisions remain between the patient and their healthcare provider.
Triple Aim does not prescribe treatment or make medical decisions.
For questions about specific program requirements, contact Triple Aim.
When the fund is closed to new applications, Triple Aim cannot accept new patient applications.
Providers may continue to review eligibility and treatment information and check the fund status for future updates.
View Fund StatusFor questions about patient eligibility, existing assistance, treatment information, or program requirements, contact Triple Aim Health Foundation.
Contact Triple AimYou can review the published eligibility requirements to see whether your patient appears to meet them.
Final eligibility is determined by Triple Aim after review of a complete application and required supporting information.
Help your patient understand their options
Review eligibility requirements, search treatment information, or contact Triple Aim with questions about patient assistance.
Questions about a patient or existing assistance? contact@tripleaimfoundation.org
